Medical Journal of Clinical Trials & Case Studies ISSN: 2578-4838 Clinical Case Study Strengthens Clinical Acumen Med J Clin Trials Case Stud Clinical Case Study Strengthens Clinical Acumen Madhav Raje 1 *, Manasi Raje 2 and Anurag Raje 3 1 Consultant Psychiatrist & Psychotherapist, Mahakali Hospital, India 2 Microfluidics Engineer at TL Biolab, USA 3 Intern at NKP SIMS, India *Corresponding author: Madhav G Raje, Mahakali Hospital, Raje's "Kamal Niwas", 210, nelco Society, Nagpur 440022, Nagpur, India, Tel: 919822947102; Email: drmadhavraje@gmail.com Abbreviations: POCT: Point of Care Tests; DMP: Decision Making Process; ACC: Anterior Cingulated Cortex; MTL: Medial Temporal Lobe; ML: Machine Learning; AI: Artificial Intelligence. Editorial Traditionally almost all medical journals publish 2 to 3 case studies/case reports which are mentioned at the bottom of the list of index and printed on the last pages. Some journals may not include a case report at times. This scenario implicitly indicates less value of case reports. Reason behind may be because all of us weigh & read research/review articles more than that of case reports. Because everybody thinks research/review articles outweighs case study/case reports. Indeed, Research/review articles are foundation of theoretical/semantic knowledge without which medical science is difficult to comprehend. But practical application of medical knowledge is not only science; many would not argue that is an art as well. Let’s rename that word “art’ as ‘skill’. Foundation of any skill is wisdom. It becomes skill when applied. Wisdom when applied in clinical set up is recognized as ‘clinical acumen’. Clinical acumen is a skill applied to form a judgment & take a correct decision accordingly, Cambridge English dictionary defines. This decision making skill of a clinician which is also referred as ‘instinct’ has become more difficult to be cultivated due to advances in biomedical engineering, computerized algorithm and that is why some researchers feel it’s ability of a few select group [1]. Biomedical engineering has with the help of microfluidics brought point of care tests (POCT) to influence diagnostic field to such an extent that patients can arrive at a diagnosis at their home without a clinician. In other conditions patient may visit doctor with his/her diagnosis and ask clinician to intervene accordingly. Such intervention though evidence/research based may not be beneficial to every patient [2]. This is because, selection of best ‘patient pertinent’ treatment journeys through 3 factors, (i) clinical state & circumstances, (ii) patient’s preferences & actions, (iii) research evidence/test results [2]. So research based or evidence based medical practice is not superior to clinician’s judgment. Many physicians opt to rely on their clinical judgment to override results of computerized algorithm [3]. In fact evidence based practice is an adjunct to clinical acumen, R.B. Haynes et al mentions in BMJ Evidence based medicine 2002 [2,3]. Having considered these factors thoroughly it is appropriate for clinician to decide best treatment option on the basis of clinical expertise & clinical acumen under the consideration of research evidence. It is called diagnosis decision making process (DMP) [4]. Diagnosis Decision Making Process (DPM) When any physician starts examining a patient, he/she starts ‘thinking’. Objective of this thinking is to evaluate many aspects of patients/case (Now onward let’s say case). Evaluate to arrive at a diagnosis. Making of a diagnosis is the primary but complex focus [5]. Driven by this focus two types of thinking takes place in the mind of physician, (1) Autonomous; which is automatic, fast, reflexive, may be erroneous & (2) analytical; which is slow, deliberate, rule and evidence based. Autonomous thinking is also called ‘intuitive thinking. Intuitive thinking is based on innate (disposition by birth) & associative learning. Associative learning takes place implicitly & explicitly during education [6]. This type of thinking is also called ‘dual thinking processes’. Approach Editorial Volume 2 Issue 3 Received Date: May 26, 2018 Published Date: June 07, 2018 DOI: 10.23880/mjccs-16000159